The Dry Eye Digest - Dry eye blog: 9/6/09 - 9/13/09skip to main | skip to sidebar Thursday, September 10, 2009Abstract: The double whammy Restasis plus steroid, for chronic dry eye.Efficacy of Combined 0.05% Cyclosporine and 1% Methylprednisolone Treatment for Chronic Dry Eye.Cornea. 2009 Aug 31. [Epub ahead of print]Byun YJ, Kim TI, Kwon SM, Seo KY, Kim SW, Kim EK, Park WC.From the *Vision Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea; daggerDepartment of Ophthalmology, Dong-A University College of Medicine, Busan, Korea; and double daggerDepartment of Ophthalmology, Soonchunhayng University College of Medicine, Bucheon, Korea. PURPOSE:: To compare the efficacy of cyclosporine 0.05% (tCSA) and combined treatment with 1% methylprednisolone on treatment of moderate-to-severe chronic dry eye. PATIENTS AND METHODS:: Forty-four patients with moderate-to-severe dry eye who had not responded to conventional treatment were treated with tCSA for 3 months. Twenty-one subjects (Group 1) were treated with 1% methyl prednisolone and tCSA for initial 3 weeks, and treated with tCSA only thereafter and 23 subjects (Group 2) were treated with tCSA only. Symptom scores, Tear break-up time (TBUT), Schirmer score, and corneal and conjunctival fluorescein staining were evaluated before and at 1, 2, and 3 months after treatment. Proinflammatory factors, interleukin-6, and interleukin-8 tear concentration were measured before and at 3 months. RESULTS:: Symptom scores, Schirmer scores, TBUT score, corneal fluorescein, conjunctival staining showed significant improvement at 1 month compared to baseline in group 1 (all P < 0.001), and all the same but few exceptions in group 2 (P = 0.002 on Schirmer, P = 0.267 on cornea stating). In symptom scores, Schirmer scores and corneal staining, greater improvements were observed for group 1 at 1 month compared to group 2 (P < 0.001, P = 0.039, P = 0.01, respectively). However, in TBUT score and conjunctival staining, there were no between-group differences (P = 0.277, P = 0.254, respectively). The time interval from treatment initiation to symptom relief was shorter for group 1 than group 2. Both groups showed decreased tear IL-6 and IL-8 concentrations at 3 months compared to baseline levels (P < 0.05). However, no between-group differences were noted in mean concentrations of IL-6 and IL-8 at baseline and at 3 months. CONCLUSIONS:: Treatment with tCSA appears to be safe and effective in moderate-to-severe chronic dry eye. Additional short-term use of a topical steroid had the benefit of providing faster symptom relief and improvement of ocular sign without serious complications.Posted by Rebecca at 1:30 PM 2 comments Abstract: Analyzing cytokines in dry eye patients Analysis of Inflammatory Cytokines in the Tears of Dry Eye Patients.Massingale ML, Li X, Vallabhajosyula M, Chen D, Wei Y, Asbell PA.From the Department of Ophthalmology, Mount Sinai School of Medicine, New York, New York.Cornea. 2009 Aug 29. [Epub ahead of print] PURPOSE:: To determine the levels of 8 important cytokines and 1 chemokine in tears of patients with dry eye disease. METHODS:: Tear samples were collected from 7 patients with dry eye disease and 7 healthy volunteers, and impression cytology samples were collected from 3 of the dry eye patients and 3 of the normal controls. Tears were analyzed for the presence of 8 cytokines [interleukin (IL)-2, IL-4, IL-5, IL-6, IL-10, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, IL-1beta] and 1 chemokine (IL-8). The cytokines and chemokine in each tear sample were measured using Invitrogen's Multiplex Bead Immunoassays. The impression cytology samples were analyzed for IL-1beta, IL-6, IL-8, and TNF-alpha mRNA expression using real-time reverse transcriptase polymerase chain reaction anlaysis. RESULTS:: All cytokines and the chemokine measured were significantly increased in the tears of dry eye patients as compared to normal controls. mRNA of all four markers was increased, and the fold increase correlated well with the fold increase of the cytokine concentration found in the tear samples. CONCLUSION:: Tears from dry eye patients contain significantly increased concentrations of cytokines that show correlation to severity of the disease. The upregulation of their respective genes in the conjunctiva suggests that the concentration increase is not the result of evaporative effects, but of overproduction. These findings suggest that cytokines may play an important role in dry eye disease and topical cytokine modulators may be explored as a therapeutic approach to dry eye disease.Posted by Rebecca at 1:25 PM 0 comments Abstract: Dry eye and chronic hepatitis C Evaluation of Ocular Surface Damage and Dry Eye Status in Chronic Hepatitis C at Different Stages of Hepatic Fibrosis.Cornea. 2009 Aug 29. [Epub ahead of print]Gumus K, Yurci A, Mirza E, Arda H, Oner A, Topaktas D, Karakucuk S.From the *Department of Ophthalmology and the daggerDepartment of Internal Medicine, Division of Gastroenterology, Erciyes University School of Medicine, Kayseri, Turkey. PURPOSE:: The purpose of this study was to explore changes in ocular surface and tear function parameters in chronic hepatitis C at different stages of hepatic fibrosis. METHODS:: Fifty-four patients with biopsy-proven chronic hepatitis C and 54 age- and sex-matched healthy control subjects without systemic hepatitis C infection were examined with the Ocular Surface Disease Index questionnaire, Schirmer with and without anesthesia, tear film breakup time, and scoring of ocular surface Lissamine green staining using modified Oxford and van Bijsterveld scoring systems and corneal fluorescein staining. RESULTS:: Patients with chronic hepatitis C scored significantly worse than the control subjects on all parameters: modified Oxford scores of Lissamine green staining (5.5/3.0; P